Living costs causing stress and fatigue on patients

SARAH CUMMING: Some doctors say patients are going without vital medicine because they just can't afford to fill the scripts at the moment. Dr Maria Boulton is President of the Australian Medical Association of Queensland, and I spoke to her a few moments ago.

DR MARIA BOULTON: I'm a GP, so this is my bread and butter and I've been doing this job for almost more than 20 years now and there's definitely been an increase in people presenting with burnout, fatigue and also mental health issues such as anxiety, depression and eating disorders, especially since COVID. And sadly, it is something that I expected. I've worked in areas that have been through environmental disasters and it is something that we do see after catastrophic events. And COVID certainly did a number on all of us and it is something that we were expecting.

SARAH CUMMING: We have spoken at length about the mental health impact of COVID. But now, of course we are adding in this cost of living crisis that we are living through. How has that compounded the issue for some people?

DR MARIA BOULTON: It's made it really hard for some people, and especially people who are having issues with finances. For example I've had patients who have come into my clinic and they're taking three scripts and they've asked me, ‘Hey, Dr Maria, I can't afford all three scripts. Which one can I do without this month?’ So certainly it's affecting patients so much that they've had to do without medications, which is catastrophic when it's medication that you know that they need.

Also, there's been a lot of stress. And when it comes to stress, especially if somebody is under financial stress, it makes it really hard for those people to seek help because, it makes it hard for them to afford that help, be it accessing their doctor, having that medication or accessing psychology services, for example. And it also adds to that extra stress of how am I going to feed my family, how am I going to pay for school fees? And it's really sad to see. And sadly, we're seeing a lot of a lot more of it now.

SARAH CUMMING: So we have this double whammy of more people in need of help and support and less people able to afford to seek out that help.

DR MARIA BOULTON: Yeah, correct. And that's the thing we want to avoid in Australia. Like we know that in many parts of the world, take the United States, there's a two-tier health system where the people that can afford the top tier get really great quality health care, but the people that can't afford it don't. So that's exactly what we need to avoid in Australia. And sadly, it is always the most vulnerable people that tend to suffer. For example, when it comes to Medicare rebates to access GPs or psychologists or allied health services, if those Medicare rebates don't keep up with the cost of providing the services, it is the most vulnerable people that are affected.

SARAH CUMMING: We are chatting to Dr Maria Boulton, President of the Australian Medical Association of Queensland on ABC Gold Coast. Dr Boulton, for people who are trying to seek help, are they able to access it? I mean, how much pressure is the whole system under? Are wait times continuing to blow out?

DR MARIA BOULTON: Wait times really blew out towards the start of COVID.  At the moment, from my personal experience, they've been quite steady, however, and they're not blowing out any more, but they're still quite long. It can be six months to see, for example, a psychologist. It is worse, though, if you're in a rural and remote area. We know that whatever we're suffering in metro areas, it’s way worse if you're out of those big cities. In some of those rural and remote areas, it can be two years for a child to access paediatric psychology services, which makes it really hard. Telehealth has helped to some extent but there's still significant waits.

Most people can access their GP quite quickly and GPs are the first port of call for most people who have mental health issues, stress, fatigue, burnout and we will continue to be there for our patients. So that's really good. However, it is really important that we also continue to have the GP workforce that we need because like every other workforce, be it allied health, pharmacists, physios, nursing, it can be quite stretched in some areas. So it's important that the government continue to look at making sure that there's enough not just of the GP workforce, but psychologists etc to ensure that everyone has access to those services.

SARAH CUMMING: I'd imagine it must be quite, stressful for GPS who are dealing with patients who are telling them, Look, I can't afford this medication and you know how desperately they need that medication. That must be stressful on your workforce?

DR MARIA BOULTON: Yes, It's really stressful to see people who are stressed or unwell or sad or depressed. It's always awful. But it is something that, sadly, we do deal with day in, day out. GPs themselves are not immune to burnout as well. And certainly COVID has seen a lot of changes in medicine and many of us have lost patients or family members to COVID as well as, you know, everybody else in the community. So we're definitely not immune to all those stressful situations.

But it's awful and I always think that one of the best parts of my day is when I see a patient that has come through to the other side and they're feeling better. That's one of the best things of general practice, when you've helped someone and they come and see you and they say, ‘I'm feeling better, I'm doing well at my job, my kids are well’ and there's nothing better. Honestly, I think it's better than fixing a broken bone, for example, because it is harder to get there and it takes a little bit longer. But there is so much we can do. And I guess if I can say something to your listeners is that if you're in any way distressed, stressed, burnt out, fatigued, please reach out to your GP and make that appointment. Sometimes that is the hardest thing. It's actually making that first appointment. But there is so much we can do to help them.

SARAH CUMMING: Maria, the Prime Minister is in Brisbane this morning to announce that the Cornwall Street Medical Centre at Woolloongabba will become an urgent care clinic providing fully bulk billed walk in care seven days a week over extended hours. And I think it's the third of 11 these so-called urgent care clinics promised for Queensland, including one on the Gold Coast. How much will clinics like these help?

DR MARIA BOULTON: We do welcome any investment into primary care, but the issue is that, even with 11 urgent care clinics in the state, Queensland is the most decentralised state. It's not going to be enough. We needed that funding to go to every Queenslander to access their GP. We needed that funding to go to every GP clinic so that they can open those extended hours. And above all, we know how important continuity of care is. We know how important it is for that patient to have access to their clinic that they go to see the doctors that they already know. Even though they do have their place, we know that Urgent Care Clinics aren't going to make that much of a difference when it comes to ambulance ramping and bed blocking hospital because that's not the patient population that they're dealing with in hospitals that are causing their issues. We've been calling for every Queenslander to have more access to their GP and this isn't going to achieve that.

SARAH CUMMING: Dr Boulton, thank you so much for your time this morning. 

DR MARIA BOULTON: Thank you.